. . . because much of the content relates both to Washington, D.C., and "outside the beltway" -- the heartland, specifically Iowa -- and because after going from Iowa to Washington via Texas and California I subsequently returned, From DC 2 Iowa.

Friday, June 19, 2009

Universal Single-Payer a Necessity Now

June 19, 2009, 11:20 a.m.

And check out "Virtualosity," June 16, 2009, and its links to prior entries.

Why Universal Single-Payer Health Care is Essential for America

A month ago in this blog I came out strongly in support of what has come to be called in our health care debate the "public option." "Public Option vs. Private Greed," May 18, 2009.

My analysis was, simply put, that as President Obama has acknowledged single-payer would make the most sense were we starting fresh. But strategically, in 2009, given all the inaccurate mud that opponents would throw at single-payer, we'd be more likely to end up with at least the public option if we lowered our sights to that. That analysis may or may not have been sound a month ago.

It is no longer sound now, in my judgment.

Everything else in that May 18th blog entry I would still stand by -- just not the strategic conclusion. Like the response to a law student's recitation attributed to a law professor, "I follow you all but the 'therefore.'"

What's changed my mind is the behavior of the special interests and the senators and members of congress they fund, along with the President's only new-found interest in even the public option.

As Johnson County Auditor Tom Slockett wrote Obama, "Mr. President, please give us a specific meaningful goal and then go the American public and tell us, 'Now make me do it.' I urge you to publicly advocate single payer, real reform. The insurance industry has had 16 years to fix the problem and they have done nothing but block real reform. Your outspoken leadership is necessary to do something about the problem. Please don't start the negotiations by throwing in the towel. There are more than 46 million reasons to do this."

Read the "Public Option vs. Private Greed" lengthy list of arguments. We're paying twice what other countries pay and we're getting less -- in terms of infant mortality, life expectancy and other measures. I'm not going to repeat all of that here.

Bottom line is that the continuously rising costs of health insurance (well beyond our overall rates of inflation), the for-profit administrative costs (some 10 times those of Medicare and Medicaid), and the multi-million-dollar packages for insurance and hospital executives are simply unsustainable.

We are operating with a dysfunctional, for-profit sickness insurance system that fails to deliver the health care the American people need -- while over-charging us for what we're not even getting.

Are there problems with government-run systems? Sure; there are problems with programs run by any large institutions. What I am now convinced of, however, based on the experience of other countries, our own experience with the public health programs we have, and the behavior of the special interest obstructionists over the past month is that the problems with government-run systems, elsewhere and here, are far, far fewer than the problem we now have.

Will it cost money? Of course. But how dare a President and Congress that have willingly handed over trillions of our dollars to their major campaign contributors in the banking, insurance and finance industries have the nerve to now tell us that "we can't afford" the kind of health care that all of the world's major industrial countries provide for their citizens!

They talk of a trillion-dollar cost -- and then whisper softly, "over ten years." That's $100 billion a year -- less than they gave in a matter of days to one company! Less than a couple months of our bloated Defense Department budget. Let's get real. Put aside humanitarian considerations; the economic return alone from every American being in better health is a far higher return than we get for almost any other investment we could make -- especially those that involve handing over hundreds of billions of taxpayer dollars to multi-million-dollar CEOs.

The special interests' behavior over the past month is what's tipped the scales for me. They have made very clear their willingness to fight true health care -- and that they have no more meaningful proposals for reform than, as Slockett notes, they have come up with over the last 16 years.

But in fairness to those special interests, they have made something else clear. Their excessive profits, their failure to control costs, their refusal to pay legitimate claims is, in one sense, not entirely their fault.

The primary fault lies in the system. It is systemic. It is simply impossible for a for-profit insurance system to deliver acceptable levels of health care for an entire nation's population.

It's like the old, rusty Honda I once drove. I would scrape off the rust and paint over the spots. The rust would always return. Why? A mechanic finally explained it to me: the rust is coming from inside not outside.

That's the problem with our sickness insurance and big pharma system: it's rusting from the inside out. It will continue to do so until the costs it hands us spiral so far out of control that they bring our entire economy down, like a third world country in bankruptcy.

The purpose of a for-profit anything, including a sickness insurance company, as the term "for-profit" suggests, is to make a profit -- and not just "a profit" but the "ever-increasing profit" that Wall Street demands. How can a sickness insurance company make an ever-increasing profit? Basically two ways: (1) increase revenue by increasing premiums, and (2) reduce costs by dropping (or refusing to insure) those with the largest claims, and fighting the payment of any claims when the company will have a possibility of prevailing. They have, and will continue to, do both.

Such a system cannot be fixed. It is folly to try and disingenuous to suggest it will ever work.

We have to join the rest of the civilized world and insist on a universal, single-payer system. It is the only way to reduce costs to manageable levels, and increase the health care of the American people to acceptable levels -- not to mention the only way American business can compete in the global economy with businesses that do not have to assume sickness insurance costs, and can still benefit from a healthier workforce than American businesses.

The transition will take time. We could begin by granting everyone a defined level of basic care, leaving some variety of "major medical" insurance to cover the other costs. There are undoubtedly a wide variety of possible transitional steps that those who've thought longer and harder than I have know about.

But the current road the President and Congress are walking is simply wrong and will lead us only deeper and deeper into the swamp we're already in.

What can you do?

For a quick and painless way to express your support for a single-payer Medicare-for-all program, click on this link to co-sign Senator Bernie Sanders' petition to Congress, and then share this link with others who care.

No Legal AdviceNothing posted on this blog is intended as, constitutes, nor should be taken to be, "legal advice," nor as creating an attorney-client relationship.

Personal ViewThis blog is neither affiliated with nor hosted by the University of Iowa or any other institution or organization. It is maintained by Nicholas Johnson in his individual capacity. Nothing posted here should be construed as anything other than the personal views of the author.